1Department of Medical Microbiology and Parasitology, College of Medicine, University of Ibadan, Ibadan, Nigeria

2Department of Obstetrics and Gynaecology, College of Medicine, University of Ibadan, Ibadan

3Department of Pharmacology and Therapeutics, College of Medicine, University of Ibadan, Ibadan, Nigeria

4Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Ibadan, Nigeria

5Department of Family Medicine, University College hospital, Ibadan, Nigeria

6Department of Chemical Pathology, College of Medicine, University of Ibadan, Ibadan, Nigeria

7Department of Virology, College of Medicine, University of Ibadan, Ibadan, Nigeria

Abstract

Introduction Syphilis and Human immunodeficiency virus (HIV) infections have been found to be major public health problems in Sub-Saharan Africa. Clinical presentation of syphilis in patients infected with HIV has been described as atypical. This study was aimed to determining the seroprevalence and risk factors of syphilis among HIV infected patients in a tertiary hospital in Nigeria.

Methods It is a descriptive cross-sectional survey of 793 HIV- infected patients enrolled at the Anti-Retroviral Treatment (ART) clinic, University College Hospital, Ibadan, Nigeria between July and December 2010. Detailed medical history was obtained from the patients after informed consent. Screening for syphilis using qualitative rapid Plasma Reagin (RPR) was performed on each of the sera/plasma collected from them. Measurement of CD4 + T lymphocyte (CD4) count was carried out by flow cytometry and Roche Ampiclor RNA PCR assay was used for the measurement of plasma HIV RNA (viral load). Data analysis was performed using SPSS version 23.

Results A total of 793 participants, 557 females and 236 males were enrolled. The mean age of the patients was 36.99±10.3 years. The overall prevalence of syphilis among this cohort of patients was 1.51% (1.4% in females and 1.7% in males). 30–39 years age groups were mostly affected with 50.0% of the cases of syphilis. The mean age, weight, CD4 count and log viral load for the syphilis co-infected HIV patients were 38.17±8.22 years, 59.8±10.5 Kg, 275.92±282.1 cells/mm3 and 4.35±1.37 copies/ml respectively compared to 36.97±10.3 years, 56.7±15.5 kg, 262.06±256.5 cells/mm3 and 4.62±1.2 copies/ml respectively in the population without syphilis co-infection. Syphilis co-infection occurs more among females (OR 1.1, 95% CI (0.75–1.58), and the married (OR 1.1, 95% CI (0.75–1.58) without significant association.

Conclusion Our study had revealed a low prevalence of syphilis in patients living with HIV/AIDS. Routine screening and counselling for syphilis should be considered for patients in AIDS care in Sub-Saharan Africa.

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